Trigger finger (stenosing flexor tenosynovitis) occurs when a flexor tendon has difficulty gliding through a tight part of its sheath near the base of the finger. The tendon may catch as the finger bends or straightens, producing a click or a temporary lock.
Symptoms
- Clicking, catching or locking during finger movement.
- Pain or tenderness in the palm at the base of the affected finger or thumb.
- Stiffness that is often worse after rest or first thing in the morning.
- A finger that has to be straightened with the other hand in more advanced cases.
Who is affected?
Trigger finger becomes more common in middle and later life and is associated with diabetes and inflammatory conditions such as rheumatoid arthritis. More than one finger can be involved.
Diagnosis
The diagnosis is usually made from the history and physical examination. Imaging is not routinely needed unless another condition is suspected.
Treatment without surgery
Reducing aggravating gripping activities, a short period of splinting and a corticosteroid injection are common options. Injection is effective for many patients, although response and recurrence vary and outcomes may be less predictable in people with diabetes.
Surgery
If triggering remains troublesome or repeatedly returns, a small procedure can release the tight pulley that is restricting tendon movement. It is commonly performed as day surgery and often under local anaesthesia.
Recovery
Finger movement is usually encouraged early after release. Temporary swelling, scar tenderness and stiffness can occur. Hand therapy may be recommended when stiffness was present before surgery or when motion is slow to return.